Abstract:

In soft tissue reconstruction of the knee and its surrounding tissue, it is important to cover the exposed structures with sufficient soft tissue and to protect the knee function. In elderly patients with multiple comorbidities and in patients with limited local flap options, it is difficult to find a good alternative except for the cross-leg flap. The distal anteromedial thigh flap provides a good local alternative flap option for the reconstruction of knee and peripatellar skin defects other than classical defined flaps. In this study, reconstruction results of complicated soft tissue defects of the knee region with distal anteromedial thigh flap are presented. Materials and Methods: Six patients (three females, three males) who were operated for knee and peripatellar skin defects between 2014-2019 were included in this study. Four of these patients were elderly and had multiple comorbidities, whereas two patients had limited local flap options due to previous compartment syndrome and necrotizing fasciitis. Results: The defects were successfully closed in all patients except one. In one of our patients who developed superficial marginal necrosis, the remaining defect was grafted successfully. The other patient who developed partial 40% necrosis, the patellar defect was closed but the pretibial region could not be closed and a cross leg flap was planned. Conclusion: Distal anteromedial thigh perforator flap is a safe option for reconstruction of knee and peripatellar skin defects in complicated cases. It may be appropriate to use the delayed flap for the defects of the infrapatellar region to prevent venous insufficiency.

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